The proposed rule amendments are intended to clarify various penalties for specific violations.

 

DEPARTMENT OF HEALTH
Board of Medicine

RULE NO: RULE TITLE
64B8-8.001: Disciplinary Guidelines
PURPOSE AND EFFECT: The proposed rule amendments are intended to clarify various penalties for specific violations.
SUMMARY: The proposed rule amendments address violations which are appropriate for continuing medical education and community service with regard to penalties. The rule also clarifies language with regard to probation following periods of suspension.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: A Statement of Estimated Regulatory Cost has been prepared and is available by contacting: Larry McPherson, Jr., Executive Director, at the address listed below.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 456.0375(4)(c), 456.50(2), 456.0575, 456.079, 458.309, 458.331(5) FS.
LAW IMPLEMENTED: 456.0375(4)(c), 456.50(2), 456.0575, 456.072, 456.079, 458.331(5) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN FAW.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Larry McPherson, Jr., Executive Director, Board of Medicine/MQA, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253

THE FULL TEXT OF THE PROPOSED RULE IS:

64B8-8.001 Disciplinary Guidelines.

(1) Purpose. Pursuant to Section 456.079, F.S., the Board provides within this rule disciplinary guidelines which shall be imposed upon applicants or licensees whom it regulates under Chapter 458, F.S. The purpose of this rule is to notify applicants and licensees of the ranges of penalties which will routinely be imposed unless the Board finds it necessary to deviate from the guidelines for the stated reasons given within this rule. The ranges of penalties provided below are based upon a single count violation of each provision listed; multiple counts of the violated provisions or a combination of the violations may result in a higher penalty than that for a single, isolated violation. Each range includes the lowest and highest penalty and all penalties falling between, including appropriate continuing medical education (CME). The purposes of the imposition of discipline are to punish the applicants or licensees for violations and to deter them from future violations; to offer opportunities for rehabilitation, when appropriate; and to deter other applicants or licensees from violations.

(2) Violations and Range of Penalties. In imposing discipline upon applicants and licensees, in proceedings pursuant to Sections 120.57(1) and (2), F.S., the Board shall act in accordance with the following disciplinary guidelines and shall impose a penalty within the range corresponding to the violations set forth below. The verbal identification of offenses are descriptive only; the full language of each statutory provision cited must be consulted in order to determine the conduct included.

 

RECOMMENDED RANGE OF PENALTY

 

VIOLATION	FIRST OFFENSE	SECOND OFFENSE	THIRD OFFENSE
(a) Attempting to obtain, obtaining or renewing a license or certificate by bribery, fraud or through an error of the Department or the Board. (458.331(1)(a), F.S.) (456.072(1)(h), F.S.)
1. No change.
2. Attempting to renew a license by bribery or fraud.	2. Revocation From revocation of the license and with ability to reapply upon payment of a $5,000 $10,000.00 fine to permanent revocation and a $10,000 fine.	2. Revocation and a $10,000.00 fine.
3. Obtaining or renewing a license by bribery or fraud.	3. Revocation From revocation of the license and with ability to reapply upon payment of a $5,000 $10,000.00 fine to permanent revocation and a $10,000 fine.	3. Revocation and a $10,000.00 fine.
4. No change.
(b) Action taken against license by another jurisdiction. (458.331(1)(b), F.S.) (456.072(1)(f), F.S.)	(b) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to suspension or denial of the license until the license is unencumbered in the jurisdiction in which disciplinary action was originally taken, and an administrative fine ranging from $1,000.00 to $5,000.00.	(b) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to revocation or denial of the license, and an administrative fine ranging from $5,000.00 to $10,000.00.
1. Action taken against license by another jurisdiction relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation or in the case of application for licensure, denial of licensure, and a fine of $10,000.00.
2. Action taken against license by another jurisdiction relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. A $10,000.00 administrative fine, 100 hours of community service, and suspension of the license, followed by a period of probation.	2. Revocation or denial and a fine of $10,000.00.
(c) Guilty of crime directly relating to practice or ability to practice. (458.331(1)(c), F.S.) (456.072(1)(c), F.S.)	(c) From probation to revocation or denial of the license, and an administrative fine ranging from $1,000.00 to $10,000.00, and 50 to 100 hours of community service.	(c) From suspension to revocation or denial of the license, and an administrative fine ranging from $5,000.00 to $10,000.00, and from 100 to 200 hours of community service.
1. No change.
2. Involving a crime related to healthcare fraud in dollar amounts of $5,000.00 or less.	2. A $10,000.00 administrative fine, compliance with any criminal probation, a reprimand, from 100 to 200 hours of community service and suspension of the license, followed by a period of probation.	2. Revocation and a fine of $10,000.00.
(d) False, deceptive, or misleading advertising. (458.331(1)(d), F.S.)
1. Negligent false, deceptive, or misleading advertising. (458.331(1)(d), F.S.)	1. From a letter of concern to one (1) year suspension or denial, to be followed by a period of probation, 50 to 100 hours of community service and an administrativefine from $1,000.00 to $5,000.00.	1. From reprimand to up to one (1) year suspension or denial, to be followed by a period of probation, from 100 to 200 hours of community service and an administrative fine from $5,000.00 to $10,000.00.
2. Fraudulent false, deceptive or misleading advertising	2. From reprimand to up to one (1) year suspension or denial, to be followed by a period of probation, 50 to 100 hours of community service and an administrative fine of $10,000.00.	2. From suspension, to be followed by a period of probation, up to revocation, from 100 to 200 hours of community service and a fine of $10,000.00.
(e) Failure to report another licensee in violation. (458.331(1)(e), F.S.) (456.072(1)(i), F.S.)	(e) From a letter of concern to probation or denial, 50 to 100 hours of community service and an administrative fine from $1,000.00 to $5,000.00.	(e) From probation to suspension or denial, from 100 to 200 hours of community service and an administrative fine from $5,000.00 to $10,000.00.
(f) Aiding unlicensed practice. (458.331(1)(f), F.S.) (456.072(1)(j), F.S.)	(f) From probation to revocation or denial, 50 to 100 hours of community service and an administrative fine from $1,000.00 to $10,000.00.	(f) From suspension, to be followed by a period of probation, to revocation or denial, from 100 to 200 hours of community service and an administrative fine from $5,000.00 to $10,000.00.
(g) Failure to perform legal obligation. (458.331(1)(g), F.S.) (456.072(1)(k), F.S.)	(g) For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a letter of concern to revocation or denial, 100 hours of community service and an administrative fine from $1,000.00 to $10,000.00, unless otherwise provided by law.	(g) For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a reprimand to revocation or denial, from 100  to 200 hours of community service and an administrative fine from $5,000.00 to $10,000.00, unless otherwise provided by law.
1. Failing to register a laser device. (456.072(1)(d), F.S.)	1. If the device is an approved device, from an administrative fine of $1,000.00 to $5,000.00; if the device is not approved, from an administrative fine from $5,000.00 to a suspensionor denial, 50 to 100 hours of community service and an administrative fine of $10,000.00.	1. If the device is an approved device, from a reprimand to probation or restriction of practice, from 100 to 200 hours of community service and an administrative fine of $5,000.00 to $10,000.00; if the device is not approved, from suspension to revocation and an administrative fine of $10,000.00.
2. Continuing medical education (CME) violations. (456.072(1)(e), F.S.) (456.072(1)(s), F.S.)	2. Within twelve months of the date of the filing of the final order, the licensee must submit certified documentation of completion of all CME requirements for the period for which the citation was issued; prior to renewing the license for the next biennium, Respondent must document compliance with the CME requirements for the relevant period; AND:	2. Within twelve months of the date of the filing of the final order, the licensee must submit certified documentation of completion of all CME requirements for the period for which the citation was issued; prior to renewing the license for the next biennium, Respondent must document compliance with the CME requirements for the relevant period; AND:	2. Continuing medical education (CME) violations. (456.072(1)(e), F.S.) (456.072(1)(s), F.S.)
a. Failure to document required HIV/ AIDS and related infections of TB or domestic violence or medical errors CME, or substituted end-of-life care CME.	a. An administrative fine of $500.00 to $1,000.00.	a. A reprimand and an administrative fine of $1,000.00 to $5,000.00.	a. Failure to document required HIV/ AIDS and related infections of TB or domestic violence or medical errors CME, or substituted end-of-life care CME.
b. Failure to document required HIV/AIDS and related infections of TB and failure to document domestic violence and failure to document medical errors CME.	b. An administrative fine of $1,000.00 to $2,000.00.	b. A reprimand and an administrative fine of $5,000.00 to $10,000.00.	b. Failure to document required HIV/AIDS and related infections of TB and failure to document domestic violence and failure to document medical errors CME.
c. Failure to document some, but not all CME hours.	c. An administrative fine of $100.00 per hour not documented.	c. A reprimand and an administrative fine of $500.00 per hour not documented.	c. Failure to document some, but not all CME hours.
d. Failure to document any CME hours.	d. A reprimand and an administrative fine from $5,000.00 to $10,000.00	d. Suspension until documentation of completion, a reprimand and an administrative fine of $10,000.00.	d. Failure to document any CME hours.
2. Continuing medical education (CME) violations. (456.072(1)(e), F.S.) (456.072(1)(s), F.S.)	2. Within twelve months of the date of the filing of the final order, the licensee must submit certified documentation of completion of all CME requirements for the period for which the citation was issued; prior to renewing the license for the next biennium, Respondent must document compliance with the CME requirements for the relevant period; AND:	2. Within twelve months of the date of the filing of the final order, the licensee must submit certified documentation of completion of all CME requirements for the period for which the citation was issued; prior to renewing the license for the next biennium, Respondent must document compliance with the CME requirements for the relevant period; AND:	2. Continuing medical education (CME) violations. (456.072(1)(e), F.S.) (456.072(1)(s), F.S.)
3. Failure to comply with the requirements of Section 381.026 and 381.0261, F.S., to provide patients with information about patient rights. (456.072(1)(t), F.S.)	3. Corrective action for nonwillful violations.	3. Administrative fine of up to $100.00 for the second and subsequent nonwillful violations; and an administrative fine from $250.00 to $500.00 for the second and subsequent willful violations with each intentional and willful violation a separate violation subject to said fine.
3.4. Failing to comply with the requirements for profiling and credentialing. (456.039, F.S.) (456.072(1)(v), F.S.); (458.319, F.S.);
a.  No change.
b. Involving violations of any provision of Chapter 456, F.S., for making misleading, untrue, deceptive or fraudulent representations on a profile, credentialing, or initial or renewal licensure application.
(I) Negligently making misleading or untrue representations on a profile, credentialing, or initial licensure or renewal application.	(I) From a $1,000.00 fine and 3 hours CME on ethics to suspension, to be followed by a period of probation, and a reprimand, 50 to 100 hours of community service and a $5,000.00 administrative fine.	(I) From suspension, to be followed by a period of probation, and a reprimand, from 100 to 200 hours of community service, and a $10,000.00 fine to revocation or denial.
(II) Fraudulently making misleading, untrue, deceptive or fraudulent representations on a profile, credentialing, or initial licensure or renewal application.	(II) Referral to State Attorney for prosecution pursuant to Sections 456.067 and 456.066, F.S., and from suspension, to be followed by a period of probation, and 100 to 200 hours of community service, and a reprimand and a $10,000.00 fine to revocation or denial and a $10,000 fine.	(II) Referral to State Attorney for prosecution and revocation or denial and a $10,000.00 fine.
5. Failing to report to the board within 30 days after the licensee has been convicted of a crime in any jurisdiction. Convictions prior to the enactment of this section not reported in writing to the board, on or before October 1, 1999. (456.072(1)(w), F.S.)	5. From an administrative fine of $2,000.00 to a fine of $5,000.00, 50 to 100 hours of community service and a reprimand or denial without the ability to reapply.	5. From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation without the ability to reapply and an administrative fine from $5,000.00 to $10,000.00.
6. Failing to comply with obligations regarding ownership and control of medical records, patient records; report or copies of  records to be furnished. (456.054, F.S.)	6. From a letter of concern to two (2) years suspension followed by probation or denial, 50 to 100 hours of community service and an administrative fine from $1,000.00 to $5,000.00.	6. From a reprimand to two (2) years suspension followed by probation or denial, 100 to 200 hours of community service and an administrative fine from $5,000.00 to $10,000.00.
7. Failing to maintain confidentiality of communication between a patient and a psychiatrist. (456.059, F.S.)	7. From a $5,000.00 administrative fine, 50 to 100 hours of community service and a reprimand to suspension, to be followed by a period of probation, and a $10,000.00 administrative fine or denial.	7. From suspension, to be followed by a period of probation, and 100 to 200 hours of community service to revocation or denial.
8. Failing to report final disposition of professional liability claims and actions. (456.049, F.S.)	8. If the licensee complies within six (6) months of the violation then an administrative fine of up to $2,000.00; if compliance after six (6) months, an administrative fine of up to $5,000.00 and a reprimand.	8. If the licensee complies within six (6) months of the violation, then a reprimand and an administrative fine from $5,000.00 to $10,000.00; if compliance after six (6) months, from suspension, to be followed by a period of probation, to revocation and an administrative fine of $10,000.00.
9. Failing to disclose financial interest to patient. (456.052, F.S.)	9. A refund of fees paid by or on behalf of the patient and from an administrative fine of $1,000.00, 50 hours of community service to a reprimand, 100 hours of community service and an administrative fine of $5,000.00.	9. A refund of fees paid by or on behalf of the patient and from restriction of practice, 100 hours of community service and an administrative fine of $5,000.00 to a reprimand, 200 hours of community service and an administrative fine of $10,000.00.
(h) Filing a false report or failing to file a report as required. (458.331(1)(h), F.S.) (456.072(1)(l), F.S.)
1. Negligently filing a false report or failing to file a report as required.	1. From a letter of concern or denial to one (1) year probation, and an administrative fine from $1,000.00 to $5,000.00.	1. From one (1) year probation to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
2. Fraudulently filing a false report or failing to file a report as required.	2. From one (1) year probation to revocation or denial and a $10,000.00 fine.	2. From suspension, to be followed by a period of probation, to revocation and a $10,000.00 fine.
3. Involving healthcare fraud in dollar amounts in excess of  $5,000.00.	3. Revocation or in the case of application for licensure, denial of licensure, and a $10,000.00 fine.
4. Involving healthcare fraud in dollar amounts of $5,000.00 or less.	4. A $10,000.00 administrative fine, 100 to 200 hours of community service, suspension of the license, followed by a period of probation.	4. Revocation and a $10,000.00 fine.
(i) Kickbacks or split fee arrangements. (458.331(1)(i), F.S.) (456.054, F.S.)	(i) A refund of fees paid by or on behalf of the patient, 50 to 100 hours of community service and from six (6) months suspension, to be followed by a period of probation, to revocation or denial and an administrativefine from $1,000.00 to $10,000.00.	(i) A refund of fees paid by or on behalf of the patient, 100 to 200 hours of community service, and from a two (2) year suspension, to be followed by a period of probation, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(j) Sexual misconduct (458.331(1)(j), F.S.) (458.329, F.S.) (456.072(1)(u), F.S.)	(j) From one (1) year suspension to be followed by a period of probation and a reprimand, 100 to 200 hours of community service, and an administrative fine of $5,000.00 to revocation or denial and an administrative fine of $10,000.00.	(j) Revocation.
(k) Deceptive, untrue, or fraudulent representations in the practice of medicine. (458.331(1)(k), F.S.) (456.072(1)(a), (m), F.S.)	(k) From probation, and 50 to 100 hours of community service; to revocation or and denial, and an administrative fine from $1,000.00 to $10,000.00.	(k) From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or and denial and an administrative fine from $5,000.00 to $10,000.00.
1. Deceptive, untrue, or fraudulent representations in the practice of medicine involving healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation or in the case of application for licensure, denial of licensure.	1. Revocation or denial without the ability to reapply and payment of a $10,000.00 fine.
2. Deceptive, untrue, or fraudulent representations in the practice of medicine involving healthcare fraud in dollar amounts of $5,000.00 or less.	2. A $10,000.00 administrative fine, suspension of the license, followed by a period of probation, 100 to 200 hours of community service.	2. Revocation.
(l) Improper solicitation of patients. (458.331(1)(l), F.S.)	(l) From one (1) year suspension, to be followed by a period of probation, 50 to 100 hours of community service, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(l) From one (1) year suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(m) Failure to keep appropriate written medical records. (458.331(1)(m), F.S.)	(m) From a reprimand to denial or two (2) years suspension followed by probation, 50 to 100 hours of community service, and an administrative fine from $1,000.00 to $10,000.00.	(m) From probation to suspension followed by probation or denial, 100 to 200 hours of community service, and an  administrative fine from $5,000.00 to $10,000.00.
1. Failure to keep appropriate written medical records involving healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation or in the case of application for licensure, denial of licensure.	1. Revocation or denial without the ability to reapply and payment of a $10,000.00 fine.
2. Failure to keep appropriate written medical records involving healthcare fraud in dollar amounts of  $5,000.00 or less.	2. A $10,000.00 administrative fine, suspension of the license, followed by a period of probation, 100 to 200 hours of community service.	2. Revocation or denial.
(n) Exercising influence on patient for financial gain. (458.331(1)(n), F.S.) (456.072(1)(n), F.S.)	(n) Payment of fees paid by or on behalf of the patient and from probation to denial or two (2) years suspension, to be followed by a period of probation, 50 to 100 hours of community service, and an administrative fine from $5,000.00 to $10,000.00.	(n) Payment of fees paid by or on behalf of the patient and from suspension, 100 to 200 hours of community service, to revocation or denial and an administrative fine of $10,000.00.
(o) Improper advertising of  pharmacy. (458.331(1)(o), F.S.)	(o) From a reprimand and $250.00 fine or denial to one year probation, to be followed by a period of probation, 50 to 100 hours of community service, and an administrative fine from $250.00 to $5,000.00.	(o) From probation, 100 to 200 hours of community service to suspension, to be followed by a period of probation, or denial and an administrative fine of $5,000.00 to $10,000.00.
(p) Performing professional services not authorized by patient. (458.331(1)(p), F.S.)	(p) From a reprimand or denial to two (2) years suspension, to be followed by a period of probation, 50 to 100 hours of community service, and an administrative fine from $1,000.00 to $10,000.00.	(p) From probation, 100 to 200 hours of community service to revocation or denial and an administrative fine of $5,000.00 to $10,000.00.
(q) Inappropriate or excessive prescribing. (458.331(1)(q), F.S.)	(q) From one (1) year probation to revocation or denial and 50 to 100 hours of community service; and an administrative fine from $1,000.00 to 10,000.00.	(q) From suspension, to be followed by a period of probation, and 100 to 200 hours of community service to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(r) Prescribing or dispensing of a scheduled drug by the physician to himself. (458.331(1)(r), F.S.)	(r) From one (1) year probation,  50 to 100 hours of community service, to revocation or denial and an administrative fine from $1,000.00 to $5,000.00, and a mental and physical examination.	(r) From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00, and a mental and physical examination.
(s) Inability to practice medicine with skill and safety. (458.331(1)(s), F.S.)	(s) From probation, 50 to 100 hours of community service, to denial or indefinite suspension until licensee is able to demonstrate ability to practice with reasonable skill and safety followed by probation, and an administrative fine from $1,000.00 to $5,000.00.	(s) From indefinite suspension, followed by probation, 100 to 200 hours of community service, to suspension for a minimum of five (5) years or until licensee is able to demonstrate ability to practice with reasonable skill and safety followed by probation, and an administrative fine from $5,000.00 to $10,000.00.
(t) Failure to practice medicine in accordance with appropriate level of care, skill and treatment recognized in general law related to the practice of medicine. (456.50(1)(g), F.S.) (458.331(1)(t), F.S.)	(t) From one (1) year probation, 50 to 100 hours of community service, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(t) From two (2) years probation, 100 to 200 hours of community service, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
1. Gross Malpractice.	1. From one (1) year suspension followed by three (3) years probation, 50 to 100 hours of community service; to revocation or denial and an administrative fine from $1,000.00 to $10,000.00 and licensee shall be subject to reexamination.	1. From suspension, to be followed by a period of probation, 100 to 200 hours of community service, or denial to revocation or denial and an administrative fine of $5,000.00 to $10,000.00, and an evaluation or reexamination by a physician evaluation program approved by the Board.
2. No change.
(u) Performing of experimental treatment without informed consent. (458.331(1)(u), F.S.)	(u) From one (1) year suspension, to be followed by a period of probation; 100 to 200 hours of community service; to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(u) Revocation or denial.
(v) Practicing beyond scope permitted. (458.331(1)(v), F.S.) (456.072(1)(o), F.S.)	(v) From two (2) years suspension; 50 to 100 hours of community service; to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(v) From suspension; 100 to 200 hours of community service; to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(w) Delegation of professional responsibilities to unqualified person. (458.331(1)(w), F.S.) (456.072(1)(p), F.S.)	(w) From one (1) year probation, 50 to 100 hours of community service; to denial or five (5) years suspension followed by probation, and an administrative fine from $1,000.00 to $10,000.00.	(w) From suspension, to be followed by a period of probation; 100 to 200 hours of community service; to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(x)1. Violation of law, rule, or failure to comply with subpoena. (458.331(1)(nn), F.S.) (456.072(1)(b), (q), F.S.)	(x)1. For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a reprimand, 50 to 200 hours of community service, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(x)1. From probation, 100 to 200 hours of community service; to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
2. Violation of an order of the Board. 458.331(1)(x), F.S.	2. Reprimand, 50 to 100 hours of community service; and an administrative fine from $5,000.00 to $10,000.00, to revocation or denial based upon the severity of the offense and the potential for patient harm.	2. From suspension, to be followed by a period of probation, 100 to 200 hours of community service; and a $10,000.00 fine or denial to revocation.
3. Failure to comply with any provision of Rule 64B8-8.019, F.A.C.	3. From a $1,000.00 fine, letter of concern, 50 hours of community service; demonstration of compliance with the rule or denial to a $5,000.00 fine, a reprimand, completion of a laws and rules course, a term of probation, 100 hours of community service; demonstration of compliance with the rule or denial.	3. From a $7,500.00 fine, a reprimand, a term of probation, completion of a laws and rules course, 100 to 200 hours of community service; demonstration of compliance with the rule or denial to a $10,000.00 fine and revocation.
(y) Conspiring to restrict another from lawfully advertising services. (458.331(1)(y), F.S.)	(y) A reprimand or denial; 50 to 100 hours of community service; and an administrative fine ranging from $1,000.00 to $5,000.00.	(y) Probation or denial; 100 to 200 hours of community service; and an administrative fine from $5,000.00 to $10,000.00.
(z) Aiding an unlawful abortion. (458.331(1)(z), F.S.)	(z) From one (1) year suspension, to be followed by a period of probation, 50 to 100 hours of community service; to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(z) From suspension, to be followed by a period of probation; 100 to 200 hours of community service; to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(aa) Presigning prescription forms. (458.331(1)(aa), F.S.)	(aa) From a reprimand to two (2) years probation, 50 to 100 hours of community service; and an administrative fine from $1,000.00 to $5,000.00.	(aa) From suspension, to be followed by a period of probation, 100 to 200 hours of community service; to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(bb) Prescribing a Schedule II substance for Office use. (458.331(1)(bb), F.S.)	(bb) From a reprimand to probation with CME in pharmacology, 50 to 100 hours of community service; and an administrative fine from $1,000.00 to $5,000.00.	(bb) From probation to suspension, to be followed by a period of probation, or denial, 100 to 200 hours of community service; and an administrative fine from $5,000.00 to $10,000.00.
(cc) Improper prescribing of Schedule II amphetamine or sympathomimetic amine drug. (458.331(1)(cc), F.S.	(cc) From probation, 50 hours of community service, to denial or two (2) years suspension followed by probation, 100 hours of community service, and an administrative fine from $1,000.00 to $10,000.00.	(cc) From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.
(dd) Failure to adequately supervise assisting personnel. (458.331(1)(dd), F.S.)	(dd) From probation, 50 hours of community service, to denial or two (2) years suspension followed by probation, 100 hours of community service, and an administrative fine from $1,000.00 to $5,000.00.	(dd) From one (1) year suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(ee) Improper use of substances for muscle building or enhancement of athletic performance. (458.331(1)(ee), F.S.)	(ee) From one (1) year suspension, to be followed by a period of probation, 50 to 100 hours of community service, to revocation or denial and an administrative fine from $1,000.00 to $5,000.00.	(ee) From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.
(ff) Use of amygdalin (laetrile). (458.331(1)(ff), F.S.)	(ff) From one (1) year suspension, to be followed by a period of probation, 50 to 100 hours of community service, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(ff) From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.
(gg) Misrepresenting or concealing a material fact. (458.331(1)(gg), F.S.)	(gg) From suspension, to be followed by a period of probation, 50 to 100 hours of community service, to denial or revocation of license and an administrative fine from $1,000.00 to $5,000.00 with ability to reapply upon payment of up to a $10,000.00 fine to denial of license without ability to reapply.	(gg) From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(hh) Improperly interfering with an investigation or a disciplinary proceeding (458.331(1)(hh), F.S.)	(hh) From suspension, to be followed by a period of probation, 50 to 100 hours of community service, to denial or revocation of license and with ability to reapply upon payment of a $5,000.00 $1,000.00 fine to denial of license without ability to reapply.	(hh) From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(ii) Failing to report any licensee in violation who practices in a hospital or an H.M.O.; or failing to report any person in violation of Chapter 456, F.S. (458.331(1)(ii), F.S.) (456.072(1)(i), F.S.)	(ii) From a reprimand to probation, 50 to 100 hours of community service, or denial and an administrative fine from $1,000.00 to $5,000.00.	(ii) From probation, 100 to 200 hours of community service, to suspension, to be followed by a period of probation, or denial, and an administrative fine from $5,000.00 to $10,000.00.
(jj) Providing written medical opinion without reasonable investigation. (458.331(1)(jj), F.S.)	(jj) From suspension, to be followed by a period of probation, 50 to 100 hours of community service to denial or revocation of license and with ability to reapply upon payment of a $1,000.00 to $5,000.00 fine to denial of license without ability to reapply.	(jj) From suspension, to be followed by a period of probation, 100 to 200 hours of community service to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.
(kk) Failure to report disciplinary action by another jurisdiction. (458.331(1)(kk), F.S.)	(kk) From an administrative fine of $2,000.00 to a fine of $5,000.00 and a reprimand, 50 to 100 hours of community service to denial or revocation of license and with ability to reapply upon payment of a $5,000.00 $1,000.00 fine to denial or revocation of license without ability to reapply.	(kk) From probation, 100 to 200 hours of community service, to suspension, to be followed by a period of probation, or denial, and an administrative fine from $5,000.00 to $10,000.00.
(ll) Improper holding oneself out as a specialist. (458.331(1)(ll), F.S	(ll) From letter of concern, 50 to 100 hours of community service, to one (1) year suspension, to be followed by a period of probation, or denial and an administrative fine from $500.00 to $5,000.00.	(ll) From reprimand, 100 to 200 hours of community service, to up to one (1) year suspension, to be followed by a period of probation, or denial, and an administrative fine from $5,000.00 to $10,000.00.
(mm) Failing to provide patients with information about patient rights and how to file a patient complaint. (458.331(1)(mm), F.S.) 456.072(1)(t), F.S.)	(mm) Corrective action for nonwillful violations.	(mm) Administrative fine of up to $100.00 for the second and subsequent nonwillful violations; and an administrative fine from $250.00 to $500.00 for the second and subsequent willful violations with each intentional and willful violation a separate violation subject to said fine.
(nn) Violating Chapter 458, Chapter 456, or any rules adopted pursuant thereto. (458.331(1)(nn), F.S.)	(nn) From a reprimand, 50 to 200 hours of community service, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(nn) From probation,  100 to 200 hours of community service; to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.
(oo)(mm) Improper use of information about accident victims for commercial or any other solicitation of the people involved in such accidents. (456.072(1)(x), F.S.)	(oo)(mm) From an administrative fine of $1,000.00 to a fine of $5,000.00, reprimand, 50 to 100 hours of community service and probation.	(oo)(mm) From reprimand to up to one (1) year suspension, 100 to 200 hours of community service or denial, and an administrative fine from $5,000.00 to $10,000.00.
(pp)(nn) Theft or reproduction of an examination. (456.018, F.S.)	(pp)(nn) Revocation or denial without ability to reapply.	(nn) Revocation or denial without ability to reapply.
(qq)(oo) Violation of  Patient Self  Referral Act. (456.053, F.S.)	(qq)(oo) In addition to any civil penalty imposed pursuant to Section 456.053, F.S., for each separate violation, from an administrative fine of $5,000.00 to an administrative fine of $10,000.00, and 50 to 100 hours of community service.	(qq)(oo) From probation, 100 to 200 hours of community service to suspension, to be followed by a period of probation, or denial, and an administrative fine from $5,000.00 to $10,000.00.
(rr)(pp) Violation of medical director clinic responsibilities. (456.0375(4)(c), F.S.)	(rr)(pp) Based upon the severity of the offense and the potential for patient harm, from a letter of concern, 50 to 100 hours of community service, to revocation and an administrative fine from $1,000.00 to $10,000.00.	(rr)(pp) Restricted from serving as the medical director of any registered clinic and based upon the severity of the offense and the potential for patient harm, from a reprimand, 100 to 200 hours of community service, to revocation and an administrative fine from $5,000.00 to $10,000.00.
1. Failure to file or renew registration form.	1. Notice of Non-Compliance if filed or renewed within 90 days. (See Rule 64B8-8.011, F.A.C.)	1. From a reprimand and a fine of $500 for each day the licensee served as director while the clinic was not registered, to permanent restriction on serving as a medical director.
2. Failure to display registration certificate.	2. Notice of Non-Compliance. (See Rule 64B8-8.011, F.A.C.)	2. Citation or a $2,000 fine. (See Rule 64B8-8.017, F.A.C.)
3. Failure to post signs identifying medical/clinical director in conspicuous location.	3. Notice of Non-Compliance. (See Rule 64B8-8.011, F.A.C.)	3. Citation. (See Rule 64B8-8.017, F.A.C.)
4. Failure to ensure that all health care practitioners employed at clinic have active, unencumbered license.	4. From probation, 50 to 100 hours of community service, to revocation, and an administrative fine from $1,000.00 to $10,000.00.	4. From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
5. Failure to review patient referral contracts or agreements executed by clinic.	5. A refund of fees paid by or on behalf of the patient, 50 hours of community service, and from an administrative fine of $1,000.00 to a reprimand, 100 hours of community service, and an administrative fine of $5,000.00.	5. A refund of fees paid by or on behalf of the patient and from restriction of practice, 100 hours of community service, and an administrative fine of $5,000.00 to a reprimand, 200 hours of community service, and an administrative fine of $10,000.00.
6. Failure to ensure that all health care practitioners employed at clinic have active appropriate certification or licensure for the level of care being provided.	6. From probation, 50 to 100 hours of community service, to revocation, and an administrative fine from $1,000.00 to $10,000.00.	6. From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
7. Failure to comply with Section 456.057, F.S., with regard to clinic records.	7. From a letter of concern to two (2) years suspension followed by probation, 50 to 100 hours of community service, and an administrative fine from $1,000.00 to $5,000.00.	7. From a reprimand to two (2) years suspension followed by probation, 100 to 200 hours of community service, and an administrative fine from $5,000.00 to $10,000.00.
8. Failure to ensure compliance with recordkeeping requirements.	8. From a letter of concern to two (2) years suspension followed by probation, 50 to 100 hours of community service, and an administrative fine from $1,000.00 to $5,000.00.	8. From a reprimand to two (2) years suspension followed by probation, 100 to 200 hours of community service, and an administrative fine from $5,000.00 to $10,000.00.
9. Failure to ensure compliance with office surgery requirements.	9. From probation, 50 to 100 hours of community service, to revocation, and an administrative fine from $1,000.00 to $10,000.00.	9. From suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
10. Failure to ensure compliance with adverse incident reporting requirements.	10. Notice of Non-Compliance if filed within 90 days. (See Rule 64B8-8.011, F.A.C.)	10. From a reprimand and a fine of $500 for each day the licensee served as director while the clinic was not registered, to permanent restriction on serving as a medical director.
11. Failure to conduct systematic reviews of clinic billings.	11. From a reprimand to two (2) years suspension followed by probation, 50 to 100 hours of community service, and an administrative fine from $1,000.00 to $10,000.00.	11. From probation, 100 to 200 hours of community service, to suspension followed by probation, and an administrative fine from $5,000.00 to $10,000.00.
12. Failure to take immediate corrective action upon discovery of unlawful billing.	12. A refund of fees paid by or on behalf of the patient and from six (6) months suspension, to be followed by a period of probation, 50 to 100 hours of community service, to revocation, and an administrative fine from $1,000.00 to $10,000.00.	12. A refund of fees paid by or on behalf of the patient and from a two (2) year suspension, to be followed by a period of probation, 100 to 200 hours of community service, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
13. Serving as medical/clinical director for more registered clinics than provided by Department rule.	13. From probation, 50 to 100 hours of community service, to two (2) years suspension followed by probation, 150 hours of community service, and an administrative fine from $1,000.00 to $5,000.00.	13. From one (1) year suspension, to be followed by a period of probation, 200 hours of community service, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
(ss)(qq) Performing or attempting to perform health care services on the wrong patient, a wrong site procedure, a wrong procedure, or an unauthorized procedure or a procedure that is medically unnecessary or otherwise unrelated to the patient’s diagnosis or medical condition. (456.072(1)(bb), F.S.)	(ss)(qq) From a $1,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, and one (1) hour lecture on wrong-site surgery in the State of Florida to a $10,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, a minimum of fifty (50) to 100 hours of community service, undergo a risk management assessment, a one (1) hour lecture on wrong-site surgery, and suspension to be followed by a term of probation.	(ss)(qq) From a $10,000.00 fine, a reprimand, a minimum of 100 fifty (50) to 200 hours of community service, undergo a risk management assessment, and probation or denial to a $10,000.00 fine and revocation.	(ss)(qq) From a $10,000.00 fine, a reprimand, 200 a minimum of one hundred (100) hours of community service, undergo a competency evaluation, and suspension to be followed by a term of probation to a $10,000.00 fine and revocation.
(tt)(rr) Leaving a foreign body in a patient, such as a sponge, clamp, forceps, surgical needle, or other paraphernalia commonly used in surgical, examination, or other diagnostic procedures. (456.072(1)(bb), F.S.)	(tt)(rr) From a $2,000.00 to a $10,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, a minimum of 50 to 100 hours of community service, and a one hour lecture to the staff of a Florida licensed healthcare facility on retained foreign body objects to revocation.	(tt)(rr) From a $10,000.00 fine, a reprimand and probation, 100 to 200 hours of community service, or denial to revocation.
(uu)(ss) For the practitioner(s) responsible for the adverse incident, failing to inform a patient, or an individual identified pursuant to Section 765.401(1), F.S., in person about adverse incidents that result in serious harm to the patient. (456.0575, F.S.)	(uu)(ss) From a reprimand to probation, 50 to 100 hours of community service, or denial and an administrative fine of $1,000 to $5,000.	(uu)(ss) From probation, 100 to 200 hours of community service, to suspension or denial and an administrative fine of $5,000 to $10,000.
(vv)(tt) Being terminated from a treatment program for impaired practitioners, for failure to comply with the terms of the monitoring or treatment contract or for not successfully completing any drug-treatment or alcohol-treatment program. (456.072(1)(gg), F.S.)	(vv)(tt) From suspension until licensee demonstrates compliance with all terms of the monitoring or treatment contract, and is able to demonstrate to the Board the ability to practice with reasonable skill and safety to be followed by a term of probation; and a fine of $1,000 to $2,500, to revocation.	(vv)(tt) From suspension until licensee demonstrates compliance with all terms of the monitoring or treatment contract and is able to demonstrate to the Board the ability to practice with reasonable skill and safety to be followed by a term of probation; and a fine of $2,500 to $10,000, to revocation.

 

(3) through (7) No change.

Specific Authority 456.0375(4)(c), 456.50(2), 456.0575, 456.079, 458.309, 458.331(5) FS. Law Implemented 456.0375(4)(c), 456.50(2), 456.0575, 456.072, 456.079, 458.331(5) FS. History–New 12-5-79, Formerly 21M-20.01, Amended 1-11-87, 6-20-90, Formerly 21M-20.001, Amended 11-4-93, Formerly 61F6-20.001, Amended 6-24-96, 12-22-96, Formerly 59R-8.001, Amended 5-14-98, 12-28-99, 1-31-01, 7-10-01, 6-4-02, 9-10-02, 12-11-02, 8-20-03, 6-7-04, 8-17-04, 1-4-06, 8-13-06, 8-29-06, 11-22-06, 1-30-07,_________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Rules Committee, Board of Medicine

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Medicine

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: August 15, 2008

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: April 18, 2008